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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 380504369
Report Date: 06/17/2025
Date Signed: 06/17/2025 03:20:23 PM

Document Has Been Signed on 06/17/2025 03:20 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:ST. NICHOLAS DAY CARE AND PRESCHOOLFACILITY NUMBER:
380504369
ADMINISTRATOR/
DIRECTOR:		TUWAI, KATHYFACILITY TYPE:
850
ADDRESS:5200 DIAMOND HEIGHTS BLVD.TELEPHONE:
(415) 550-1536
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94131
CAPACITY: 70TOTAL ENROLLED CHILDREN: 54CENSUS: 54DATE:
06/17/2025
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:25 AM
MET WITH:Kathy TuwaiTIME VISIT/
INSPECTION COMPLETED:
03:30 PM
NARRATIVE
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On June 17, 2025 at approximately 9:25am, Licensing Program Analyst (LPA) Catrina Quimbo conducted an unannounced, plan of correction (POC) visit to St. Nicholas Day Care and Preschool. LPA met with director, Kathy Tuwai, and explained the purpose of the visit to director. Present during LPA's visit included 10 staff with 54 preschool children. All staff present have fingerprint clearance on file.

On April 29 2025, LPA conducted an unannounced annual inspection in conjunction with a complaint visit. During visit, facility was issued one Type A citation and two Type B citations. Facility was issued a Type A citation for staff handling a child in a rough manner. Facility was also issued Type B citations for exceeding teacher to child ratios and for the facility being in disrepair.

During today's visit, LPA conducted classroom observations and reviewed documentation.

Director provided LPA proof that a formal staff meeting was conducted, addressing personal rights. Documentation submitted to LPA included the agenda of the meeting, training steps on how to appropriately transition children, personal rights reminders and staff attendance. Director also plans to have an additional, formal, staff training from an outside vendor with additional reminders on children's personal rights. LPA observed completed Acknowledgement of Receipt of Licensing Reports (LIC9224) in random selection of children's files. Deficiency has been cleared.

In the atrium, LPA observed padding on poles to be replaced, new and in good condition. LPA observed ceiling in atrium to be cleaned and with a tarp on the outside of the facility for shade. Documentation was provided to LPA during today's visit that specifies dates atrium ceiling was cleaned, sealed and inspected. Documentation that the floor replacement is scheduled, will be sent to LPA by the end of this week. When documentation is received, LPA will clear deficiency.
(Continue Report on page 2...)
NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Catrina Quimbo
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 06/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/17/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 4
California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: ST. NICHOLAS DAY CARE AND PRESCHOOL
FACILITY NUMBER: 380504369
VISIT DATE: 06/17/2025
NARRATIVE
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During today's visit, LPA observed the three preschool classrooms. LPA observed Honeybees classroom to have 15 children and 4 staff (1 qualified teacher), Rainbows classroom with 16 children and 3 staff (1 qualified teacher and 1 aide) and Sunshine classroom with 18 children and 3 staff (1 qualified teacher). Teacher to child ratio was not being met during LPA's visit conducted on this date. Deficiency previously issued during annual inspection cannot be cleared at this time.

LPA discussed with director the ratio of one aide assisting a qualified teacher cannot exceed 15 children. Director stated they have fully qualified teachers who are currently out for vacation. LPA discussed with director a staff member that does not have any early childhood education (ECE) units are not qualified teaching staff and are not counted towards teacher to child ratio. LPA to conduct a follow up visit to verify ratios are being met.

A repeat violation has been issued during today's visit. Civil penalty was also assessed. Please refer to 809D for additional information. Appeal rights were provided. A plan of correction was discussed with director.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and the report was reviewed with director, Kathy Tuwai.
NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Catrina Quimbo
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2025
LIC809 (FAS) - (06/04)
Page: 3 of 4
Document Has Been Signed on 06/17/2025 03:20 PM - It Cannot Be Edited


Created By: Catrina Quimbo On 06/17/2025 at 01:38 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: ST. NICHOLAS DAY CARE AND PRESCHOOL
FACILITY NUMBER: 380504369

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/17/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/18/2025
Section Cited
CCR
101216.3(b)(1)

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101216.3 Teacher-Child Ratio (b)(1) A ratio of one fully qualified teacher...and one aide for every 18 children in attendance...when the aide meets the qualifications specified in Section 101216.2(d).
This requirement was not met as evidenced by:
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Director has previously provided LPA with a written plan of where qualified staff will be in each classroom. Director stated they are aware of teacher to child ratio and what qualifications are needed for an aide and teacher. Director stated approximately 29 children will be leaving and/or graduating from preschool program by the end of July.
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Based on observation, interview and record review, the licensee did not comply with the section cited above. LPA observed one qualified teacher and three assistants with 15 children in the Honeybees classroom. LPA also observed one qualified teacher and 2 assistants with 18 children in the Sunshine classroom. Assistants present do not qualify as aides and are not counted towards ratio, which poses an immediate health, safety or personal rights risk to children in are.
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Director stated they will place their qualified staff in each classroom appropriately with the appropriate ratios. LPA to conduct a follow up visit.

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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Marie Rodriguez
NAME OF LICENSING PROGRAM MANAGER:
Catrina Quimbo
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 06/17/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/17/2025


LIC809 (FAS) - (06/04)
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